Have you ever heard someone saying that they have “slipped a disc”? Well lets work to clarify exactly what may be going on with that lower back pain that has suddenly started and debunk a couple of the myths around what happens in your back.
First of all we need to have a look at the anatomy of the spine. Each spinal segment is made up of 3 main elements. Two vertebrae or the bones of the spine, and then a disc which sits between them. The disc is held in place by a number of different structures and contrary to the popular phrase “slipped disc” the disc doesn’t move or slip at all.
So what actually does happen then? Well if the lower back pain you are experiencing is due to a disc issue then there could be a number of different reasons.
First of all it could be something as simple as a ligament strain. There is a ligament that surrounds the disc, and like any ligament in the body, you can strain or pull it, through accidents, trauma or sudden vigorous exercise. As a ligament strain can be exceptionally painful at the best of times, doing this to a ligament that helps to stabilise your spine can add an extra level of pain into the mix. Ligaments need rest and treatment in order to heal, as they do not have their own blood supply it is important to have manual therapy to get the blood flow increased in the area.
If there has been damage to the disc itself, then there may be a bulge or prolapse of the disc. This is where the disc, which is basically a flattened ball filled with a dense fluid, has had a part of the wall weakened and so the contents will push the wall outwards. These slight alterations of the disc shape can cause pressure onto nearby structures, most commonly the spinal cord or the nerves that arise from the cord. This will depend on where the bulge or prolapse is situated and how severe it becomes. Some prolapses and bulges are completely asymptomatic and you may never realise that they are there, or they could be the cause of back or leg pain. Again if there is any pain or discomfort seek a review by a manual therapist in order to assess the level of severity.
Last, but certainly not least is when the wall of the disc has become so weak that it breaks, or herniates. A herniated disc will be extremely uncomfortable or painful as the leaking contents will aggravate the surrounding tissues causing inflammation as well the altered structure of the disc and spinal segment causing loss of support and stability and potentially strong levels of back or leg pain.
It is impossible to tell without imaging techniques such as MRI or X-Ray what is happening to the discs in the spine, and sometimes incredibly painful back pain can be caused by any of the types that have been discussed so far, but equally there could be many other causes of back pain so it is important to always seek expert opinion and advice.